Service of Orthopedics and Traumatology, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 4, 1011, Lausanne, Switzerland.
Service of Orthopedics and Traumatology, Lausanne University Hospital and University of Lausanne, Avenue Pierre-Decker 4, 1011, Lausanne, Switzerland.
Eur J Surg Oncol. 2020 May;46(5):898-904. doi: 10.1016/j.ejso.2020.01.025. Epub 2020 Jan 30.
Treatment of soft tissue sarcomas (STS) should only be initiated once the diagnosis is fully established. Resection of tumors of unknown nature should be avoided. Nevertheless, specialized centers continue to face numbers of unplanned excisions (UPE) in STS.
To compare oncologic and functional outcomes, number of surgeries, length of hospital stay and treatment costs of UPE versus planned excision (PE) in STS.
A retrospective single tertiary center study was performed on 201 patients. Survival, local and distant recurrence rates were compared between PE (n = 137) and UPE (n = 64). In a subgroup analysis of 60 patients, functional outcome (MSTS and TESS scores), and socio-economic impact (number of surgeries, length of hospital stay and treatment costs) in "functional planned excision" (fPE) group (n = 30) and "functional unplanned excision" (fUPE) group (n = 29) were compared.
There was no significant difference in oncological outcome between PE and UPE. In the subgroup analysis, we found a non-significant difference in functional outcome. Patients in the fUPE had significantly more surgeries (3.5 vs. 1.4; p < 0.00001) and costs of their management was 64% higher than fPE (p = 0.048). Hospital stay was longer after fUPE but not statistically significant (18.3 days vs. 11.8 days; p = 0.13).
Even though oncological and functional outcomes are comparable after PE and UPE of STS, the number of surgeries, length of hospital stay and treatment costs were higher in patients with UPE. Our data underscore the importance of specialized STS treatment centers including multidisciplinary management.
软组织肉瘤（STS）的治疗应在明确诊断后进行。应避免切除性质不明的肿瘤。然而，专业中心在 STS 中仍会面临数量不定的意外切除（UPE）。
比较 STS 中 UPE 与计划性切除（PE）的肿瘤学和功能结果、手术次数、住院时间和治疗费用。
对 201 名患者进行回顾性单中心三级研究。比较 PE（n=137）和 UPE（n=64）患者的生存、局部和远处复发率。在 60 例患者的亚组分析中，比较“功能计划性切除”（fPE）组（n=30）和“功能非计划性切除”（fUPE）组（n=29）的功能结果（MSTS 和 TESS 评分）和社会经济影响（手术次数、住院时间和治疗费用）。
PE 和 UPE 之间的肿瘤学结果无显著差异。在亚组分析中，我们发现功能结果无显著差异。fUPE 患者的手术次数明显更多（3.5 次与 1.4 次；p<0.00001），管理费用也高出 fPE 组 64%（p=0.048）。fUPE 后的住院时间更长，但无统计学意义（18.3 天与 11.8 天；p=0.13）。
尽管 STS 的 PE 和 UPE 后的肿瘤学和功能结果相当，但 UPE 患者的手术次数、住院时间和治疗费用更高。我们的数据强调了包括多学科管理在内的专业 STS 治疗中心的重要性。
